Health Insurance Products We Offer
The world is constantly changing and so are your health insurance needs. Blue Chip Financial Group will look at your current health insurance plan to make sure that it is the best fit for your lifestyle and budget, at no cost. We have broker relationships with a number of carriers and we customize health insurance programs to meet your needs today and in the future.
For over 25 years Blue Chip Financial Group has developed customized insurance solutions for a range of commercial and business clients, nonprofit organizations, individuals and families.
We offer Employee Benefits Insurance including health, life, disability and long term care. We have the ability to roll these benefits into retirement plans as individuals age out of the group plans that they have at work.
Blue Chip Financial Group is staffed by experienced personnel who have extensive experience and training with designations that are considered the top programs in the insurance industry. We understand the needs of a broad base of markets and businesses. We respect the individuality of the people and organizations we work with, and design insurance programs geared to the needs of each company, institution, family or person.
Individual and Family Health Insurance
Under the current health insurance law, individuals still have many choices to the type of health insurance that works best for them. As discussed before individuals can go on the exchange and get a plan that is subsidized by the government which is lower priced than the off exchange plans but there are a couple of factors that the individual needs to keep in mind for on exchange plans.
NYS of Health Exchange plans for individuals are categorized by metal types such as bronze, silver, gold and platinum. These metal categories offer different levels of coverage. The biggest factors are the copays, deductibles, and premiums. The major drawback of the NYS of Health Exchange plans is that all of them are HMO’s. We feel that HMO’s are not for everyone. The main factor for saying this is an HMO limits your choice to the medical services that the individual. The choices are limited to the network that the plan offers. This is a very important factor that most people overlook. Also the income subsidy is very low to become eligible to receive government money to help pay for the plans. The main part of being in network, is that your covered services are only for medical services that participate with the plan. We feel that is this is a serious drawback and that residing in the Capital District we are at a major disadvantage because of the lack of any “Centers of Excellence”. Albany Med and St. Peters hospitals are only regional hospitals they are not “Centers of Excellence”. What this means is that if the individual has a serious problem that is not a common problem such as gull bladder but M.S. or Lupus etc. the individual seeking expert opinions and services is going to pay 100% out of pocket to obtain out of network services.
Off exchange plans for individuals offer more choices and the full premium for these plans is very close to the unsubsidized on exchange plans. We like to recommend these plans to individuals because the individual can now choose between HMO’s, EPO’s, and PPO’s. EPO’s and PPO’s offer larger networks and more choices for medical services.
Most family health insurance plans are similar to the individual plans but the premiums reflect the increased number of participants.
When possible, we recommend the Child Health Plus plans for children that are under the age of 19. Generally this is less expensive way to cover the children and the parent or parents can now be covered as individuals or 2-person plans. Having the children covered under the Child Health Plus program works for both on and off exchange programs.
Small Business Plans
Health insurance is expensive, complicated, and sensitive. A lot can go wrong.
But small business health insurance is a must if you're looking to grow. It can help attract and retain better employees, improve productivity by keeping everyone healthy, and might even save you some money with tax credits and deductions.
(Not to mention, if you have 50 or more full-time employees, you legally have to offer health insurance. Perhaps this could change next year, but for now, let's assume so.)
Where do you start your search, though? These 4 options are some of the best out there. Take a look below and decide which is right for you and your small business.
If you're a freelancer, consultant, or sole proprietor, then you'll probably need to purchase individual health insurance.
As an individual, you only need to satisfy your own health-related needs (and those of your dependents). Keep in mind the following while looking at plans:
- Prescription medicine you need
- Personal and family medical history
- Your medical practitioner habits (How often do you visit a generalist or a specialist, for example?)
Most small businesses go with "small group" healthcare, where the risks are spread out among the employers and employees. But with a single individual, that doesn't quite work so well--that's why, in most states, only groups of 2 or more are eligible for small group health insurance.
However, some states do allow "groups of one" to quality for small business health insurance--which is especially useful if you have a chronic condition and might struggle to get affordable individual health insurance.
SHOP, or the small business health options program, is a part of the Affordable Care Act.
Here's the rundown:
If you have between 1 and 50 employees, you're eligible to select healthcare coverage plans from your state's SHOP marketplace. You can filter through Bronze, Silver, Gold, and Platinum--that indicates their prices. Once you pick your "Metal level," your employees can go into the marketplace and pick whichever plan that works best for them in your category.
You'll rest assured knowing your expenses will remain the same no matter the specific plan, your employees will appreciate being able to choose their insurance plan, and your business might even benefit from a tax credit. If you have 25 or fewer employees, you should investigate this possibility--it might save you quite a bit of money on your health insurance.
A private health exchange, also called a purchasing alliance, is sort of like a privatized version of a SHOP marketplace.
You pick a private health exchange to work with, paying only a set amount per employee depending on what percentage of their medical costs you want to cover. Meanwhile, your employees will get to pick and choose their specific plans based on those offered by the purchasing alliance.
With a private health exchange, you don't get the tax credits or huge selection of the SHOP marketplace. However, these options can be more competitively priced or higher quality, come with success agents who can advise you, and often let your employees spend pre-tax dollars on health insurance to save money.
If you want to put in the time and energy, purchasing a small group health insurance plan directly from a provider could save you money.
While this might satisfy your inner entrepreneur and cut some costs, there are a few ways this could go sour. First, some insurers simply don't sell direct--so your selection is more limited than you'd think.
Second, you'll be the one responsible for all paperwork regarding initial enrollments, yearly open enrollment periods, billing, eligibility, and claims. It's not the most efficient process, and it won't get easier as you grow.
Finally, there's a good chance that you miss a better plan because you're unfamiliar with the industry or make a purchasing mistake because of confusing terminology. Health insurance is a complicated area with lots of choices, and messing up could mean a lot of time and money wasted.
While there are a few other options--like checking out your employees' individual health insurance plans--these 4 paths are some of the best choices for your small business. These paths could change in 2017 with the new administration, but for now, they're the best place to start.
Remember: always keep in mind the health care needs of you and your employees, and figure out how much your business can spend!
NY State of Health Plans (Obamacare)
Want to know more about the health reform law and what it means for people without employer-based health insurance? The Affordable Care Act (ACA) is a complex piece of legislation but we’ve compiled this workbook to help you understand the basics. We’ll walk you through it all in three steps.
Negotiated Rates: It’s not unheard of for hospitals to charge $1.50 for one Tylenol (an entire bottle costs $1.49 on Amazon.com); or $1,200 an hour for a nurse’s services. When you have health insurance, your insurance company has negotiated prices between hospitals, doctors and insurance companies and can typically lower the initial bill anywhere from 20%-50%. (Statistic courtesy of Bills.com)
Co-pays: Co-pays are not available on every plan, but in most areas you’ll have plans that include them as an option. What’s a co-pay?: A co-pay is a flat rate you’ll pay for a specific service. Once the co-pay is paid, an insurance company usually handles the remainder of the covered medical expenses. How does a co-pay work?: In 2015, the average cost of doctor’s office visit for a new patient without insurance was $160, according to John Hopkins Bloomberg School of Public Health. If your medical plan includes $25 doctor visit co-pays, you’ll be responsible for the $25 co-pay and the insurance company would pay the rest.
Deductible: The first and usually the most critical item you want to look at when shopping for a health plan is the deductible. A deductible is the amount of money that you must pay before the insurance company will start to assist with your medical bill. Coinsurance: Some plans have coinsurance, a cost-sharing requirement you’re responsible for once your deductible has been met. It’s usually defined as a percentage of the covered cost of your medical expenses. The insurance company pays the remaining percentage of the covered medical expenses. Out-of-Pocket Maximum: For 2017, the Affordable Care Act limits out-of-pocket maximums to $7,150 for individual coverage and $14,300 for family coverage. Therefore, once a deductible is met, an individual is only responsible for the coinsurance percentage until the out-of-pocket maximum is reached.
Here is an example of how insurance cost-sharing works: Let’s assume you have health plan with a $1,000 deductible, 20% coinsurance, and a $6,000 out-of-pocket maximum. $1,000 Deductible 20% Coinsurance $6,000 Out-of-Pocket Maximum Deductible If you incur a $50,000 medical bill, you will first need to pay your $1,000 deductible. That would leave you with $5,000 left before you reach your $6,000 out-of-pocket maximum. Coinsurance With 20% coinsurance, you would pay $1,000 for every $4,000 paid by your insurance company. That means, for the next $25,000 in covered medical expenses you would pay $5,000 and your insurer would pay $20,000. Out-of-Pocket Maximum Once you’ve paid your $1,000 deductible and $5,000 in coinsurance, you’ve reached your $6,000 out of pocket maximum. Altogether, with this $50,000 medical bill, you will have paid $6,000 and your insurer will have paid the remaining $44,000.
How much coverage is provided? All of the new reformed plans will have a “metallic” benefit level designed to allow consumers to make more informed decisions when comparing plans. These metallic benefit levels start with a minimum benefit level of 60% and go up to 90% of the plan’s “actuarial value.” “ The actuarial value is equal to the percentage of total average costs for covered benefits that a plan will pay.” If your plan has a 60% actuarial value your insurer would pay an average of 60% of all of the covered medical costs on that plan and you would be responsible for 40% of covered medical costs, until you reach your plan’s cost-sharing or “out-of-pocket” limit.
The law also limits out-of-pocket costs like coinsurance, co-pays and deductibles. If your income is below 400% of the Federal Poverty Level (FPL), the ACA places tighter restrictions on your cost-sharing and uses additional subsidies to cap your out-of-pocket costs. The ACA restricts the out-of-pocket limit on all plan’s to the amount allowed for health plans with Health Savings Accounts (HSAs): $7,150 for an individual and $14,300 for a family in 2017.